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Doctors and administrators perceive culture differently

An organizational culture study surveying physicians, and a companion study of hospital administrators, found a disconnect between doctors and administrators on issues of cultural fit and organizational performance.

Doctors, the survey by Physician Wellness Services and Cejka Search found, place a great deal of importance on cultural fit but hospital administrators underestimate the importance doctors place on it.

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And while hospital administrators scored their organizations high on cultural competence – attributes such as transparent and respectful communications – physicians scored their organizations lower.

“In our experience, cultural fit has always been a significant driver of whether a physician (is) successful in a given practice,” said David Cornett, senior vice president, business development, of healthcare-focused search firm Cejka Search. “We see time and again that compensation and benefits aren’t the only incentives physicians look for in a practice opportunity.”

Industry experts watching the continued employment of physicians by hospitals have long been stressing the importance of cultural fit in such relationships. Lack of fit, they say, leads to, among other things, frustration, lower productivity and motivation, and higher turn over.

Culture and cultural issues are often hard to articulate, said Robert Stark, MD, and Liz Ferron, consultants for Physician Wellness Services, in a joint response emailed to Healthcare Finance News. This makes it tougher for administrators and physicians to address.

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While the two groups may differ on how much importance they place on particular cultural attributes, they often agree, fundamentally, on many things. The trouble is, Ferron and Stark said, they are often operating off of different perceptions. “They may be using the same words but speaking different languages,” Ferron and Stark said.

“Administrators and physicians also may need to be aware of and acknowledge they have fundamentally different training and work styles that influence their perceptions of communication and respect,” said Ferron and Stark. “Administrators tend to approach issues in global terms, working collaboratively with many groups and considering the organization’s limitations. Physicians are trained (to) address problems quickly and autonomously, using all available methods regardless of cost. They are trained in a hierarchical environment with constant scrutiny from peers, patients, payers, administrators and others. It’s important to be aware of these differences as the two groups work toward mutual definitions of communication and respect.”

To help both groups align on cultural issues, Ferron and Stark suggest that administrators define their current culture. Develop a list of cultural attributes and a definition of those attributes, then ask for confidential input from physicians.

“For each cultural attribute, ensure that there is agreement about what it is, and the day to day behaviors and actions that support it at the individual, workgroup and organizational levels,” Ferron and Stark said.

“By following this process, not only are differing expectations addressed, but administrators and physicians can make sure that their understanding of cultural attributes and related issues are in synch.”


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